SOUTHAMPTON GLOBAL HEALTH
Some Highlights from the Southampton Global Health Day held on 10th October, 2014, in the Heartbeat Lecture Theatre, University Hospital Southampton
Michael Marsh, Medical Director at Southampton, introduced the day and together with Lord Ian McColl, awarded the Global Health Prize for contributions made in the hospital to global health to Ollie Ross.
John Acres described how virtually all the NHS Trusts in Wessex have some form of link with Low and Middle Income Countries. This had been revealed by the work undertaken prior to setting up the Wessex Global Health Network and Southampton has some of the most significant links in Wessex.
The history of how Southampton became involved in its several partnerships, including Afrikids, was given by Lena Samuels, a Non-Executive Director. Andrew Jones, from the Tropical Health Education Trust (THET), described some of the work of THET in relation to partnerships nationally and used a short video “Imagine” to illustrate the importance of training local staff. This turned out to be an issue that emerged as a theme from the examples of work described during the day.
The global context of disease in which the work of Southampton is taking place was given by Paul Roderick. He illustrated global epidemiology using a mapping system that graphically showed where the burden of global health problems was most abundant. Marie-Louise Newell provided an in depth example for one disease, HIV/AIDS, where sub-Saharan Africa bears the greatest burden and she described the strategy needed to manage this for the future.
Lord McColl illustrated practical ways in which those in which people in the UK can contribute treating diseases abroad. He showed some of the dramatic effects that surgery can have both to save life, make life bearable and re-integrate people back into the community, their disability or deformity having led to their exclusion by society. Many of his examples from work on the Mercy Ships were further illustrated later in the day Richard Newsom (organiser of the event) with surgery to recover sight and showed people’s immediate reactions when dressings were removed after eye surgery.
Karinya Lewis described her experiences as an ophthalmology specialty registrar in South Sudan where she worked as a volunteer in a very remote poor area. She did what she could with little in the way of facilities before moving to the capital to help develop and plan a service. She is now supporting a Vision 2020 initiative to support training in the country.
As the day went on a theme to do with the organisation of care began to emerge. The organisation of eye surgery on the Mercy Ships allowed, for example, far more people to be treated than in the traditional day patient setting in Southampton.
Ollie Ross showed how well organised training enabled anaesthetic care to be provided in remote areas of Nepal by non-medical staff, something that would have been unachievable and unsustainable if there was reliance only on doctors. Malvena Stuart-Taylor gave similar experiences of training support for non-medical staff, which also reduced the chances of individuals moving away from rural areas and into the towns.
Martin Prevett described the treatment of chronic diseases, particularly epilepsy, in Ethiopia. Using existing organisational structures, training for staff in primary care overcame barriers of geographical access and achieved outcomes more efficiently and for more people.
Bringing this back to day to day work in the UK, the question of how to bring about improvements in health service delivery was part of the theme of Peter Campbell’s talk. Using his experiences of the Soviet system, he asked whether Soviet Healthcare was coming to the West He proposed that a management culture of fear with total focus on targets led to reductions rather than improvements in the quality of outcomes. What was required was a belief that people wanted to do a good job and to find ways to support them in this.
Perhaps this was a take home message for the day.